title: Regional differences in the use of sentinel lymph node biopsy for melanoma: a potential quality measure.
abstract: Sentinel lymph node biopsy (SLNB) provides accurate nodal staging in patients with melanoma. However, its prevalence across geographic regions is unknown. Our aim was to determine if SLNB for melanoma has been widely adopted throughout the United States. All patients in the Surveillance, Epidemiology and End Results (SEER) cancer registry for 2004 with melanoma were evaluated. Data were collected for demographics, depth of melanoma, and type of nodal evaluation (regional lymph node dissection vs SLNB). Registry sites were categorized into West, Midwest, Northeast, and Southeast. Chi2 analysis was performed to identify regional differences in receipt of SLNB. Overall, the West region (n = 2352) had a higher use of SLNB compared with the Midwest (n = 497), Northeast (n = 630), and Southeast (n = 268) regions (82.1% vs 77.9%, 65.4%, and 60.1%, respectively; P < 0.001). Intermediate-thickness (1 to 4 mm) melanomas had differences in SLNB use between the West and Midwest (83.6% and 81.4%) versus the Northeast and Southeast (66.3% and 60.2%) (P < 0.05). This population-based analysis shows low use of SLNB for melanoma in some U.S. regions. Further studies need to address the reasons for these differences and target ways to improve rates. Results suggest that SLNB may be considered as a potential quality measure.
authors.affiliation: Department of Surgery, University of California, Irvine, Orange, California 92868, USA. klane@uci.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Lane
authors.forename: Ashley
authors.initials: A
authors.lastname: Kempf
authors.forename: Cheryl
authors.initials: C
authors.lastname: Magno
authors.forename: John
authors.initials: J
authors.lastname: Lane
authors.forename: John
authors.initials: J
authors.lastname: Butler
authors.forename: David
authors.initials: D
authors.lastname: Hsiang
authors.forename: Sheldon
authors.initials: S
authors.lastname: Greenfield
authors.forename: James
authors.initials: J
authors.lastname: Jakowatz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000473:pathology*; D009367:Neoplasm Staging / Q000592:standards*; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D018426:SEER Program / Q000706:statistics & numerical data; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology